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Genetic counseling: Ovarian Cancer
Ovarian Cancer Contracting *Before we get started, I want to give you a chance to ask any questions or express any concerns that you may have. *What issues do you want to make sure we discuss? What do you want to gain from our session today? *Our plan: **talk about your medical history and diagnosis **discuss your family history in a little more detail **talk about the genetics of hereditary cancers **we'll explain what we see and discuss your risks **talk about genetic testing - what it tests, limitations **discuss ways for you to stay healthy Medical History *Tell me how you got to this point. How was your ovarian cancer diagnosed? *Fill out intake with details. *Any other medical illnesses, surgeries, or hospitalizations? Family History *Update pedigree with details. A pedigree is our "physical exam". Gives us clues as to whether the cancer is hereditary. It's important to know who has AND who doesn't have cancer. **Very specific questions about the cancer in different family members **Age at diagnosis **Current age & screening practices **Age at death & specific cause of death **Primary site of cancer (type, location, stage, laterality) **Metastasis or any new primary cancers **Methods of treatment/surgery **Any types of precancerous lesions **Ethnic background **Environmental exposures **Lifestyle issues (diet, exercise, stress) **Screening habits of "unaffected" relatives **Any other medical conditions that may be associated with cancer **any family hx of early heart attacks, blindness, deafness, birth defects, or multiple miscarriages Cancer Epidemiology *Cancer is the uncontrolled growth of cells. All cancers are genetic, but not all are inherited. It is a multifactorial disorder, caused by both genetic and non-genetic factors. *Cancer is a very common disease. 1 in 2 men and 1 in 3 women will develop some form of cancer in their lifetimes. The most common cancer sites are lung, breast, prostate, and colon. *In the U.S., 1 in 55 women will develop ovarian cancer (1.8% lifetime risk) **5-10% of all ovarian cancer is hereditary (meaning that it runs in families) **90% of this is caused by a BRCA1 or BRCA2 mutation *In the U.S., 1 in 8 women will develop breast cancer over their lifetimes. **Average age of developing cancer is 62 (2/3 of the women will be over 55) **5-10% of all breast cancer is hereditary. Of this, 2/3 (66%) of it is due to a BRCA1 or BRCA2 mutation **This gene is the link between breast and ovarian cancer. Red Flags *How do we know when a cancer is hereditary? We look for clues (red flags). *What makes us suspicious: **more than one generation affected **multiple close relatives affected on the same side of the family **early age of onset (before 50) **bilateral cancer or more than one type of cancer in the same person **rare or unusual cancers Genes and Chromosomes *Hereditary cancers are caused by a change in a specific gene that is passed on through a family **Genes are made of DNA. They have all the instructions for how our bodies grow and develop. **When there is a change in a gene, it causes the cell to not work properly, so it can grow out of control and become cancerous. *Genes are packaged on chromosomes. Chromosomes come in pairs, and we inherit one from mom and one from dad. *This gene is autosomal dominant, so only need one copy of it to inherit a higher risk of cancer. There is a 50% chance of getting it from our parents. If we carry the gene, then we have a 50% chance of passing it on. Notes The information in this outline was last updated in 2002. This material has been imported fom the wikibook "Genetic counseling"[ http://en.wikibooks.org/wiki/Genetic_counseling] under the GNU Free Documentation License.